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Home-Based Compared with Hospital-Based Rehabilitation Program for Patients Undergoing Total Knee Arthroplasty for Osteoarthritis

A Systematic Review and Meta-analysis of Randomized Controlled Trials

Li, Donghai MM; Yang, Zhouyuan MM; Kang, Pengde PhD, MD; Xie, Xiaowei MD

American Journal of Physical Medicine & Rehabilitation: June 2017 - Volume 96 - Issue 6 - p 440–447
doi: 10.1097/PHM.0000000000000621
Literature Review

Objective The aim of this study was to compare the effects of home-based with those of hospital-based rehabilitation on patients undergoing total knee arthroplasty (TKA).

Design PubMed, Web of Science, EMBASE, and Cochrane Library were systematically searched for randomized controlled trials; the studies were assessed with the modified Jadad scale. Ten trials involving 1240 patients were eligible for meta-analysis.

Results The results revealed that home-based rehabilitation is not inferior to hospital-based rehabilitation according to the total Western Ontario and McMaster Universities Osteoarthritis index score, physical function, stiffness, walk test, and Oxford Knee Score at 12 or 52 weeks after TKA (P > 0.05). Neither pain nor knee flexion range of motion differed between the groups in the first 12 weeks. Unexpectedly, the pain score in the hospital-based group was better than that in the home-based group (P < 0.05), whereas the knee flexion range of motion in the home-based group was superior to that in the hospital-based group (P < 0.05) at 52 weeks. The meta-analysis revealed that the 2 rehabilitation programs have similar costs (P > 0.05).

Conclusion Home-based rehabilitation after primary TKA was comparable to hospital-based rehabilitation and thus is a significant alternative for patients.

From the Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China.

All correspondence and requests for reprints should be addressed to: Pengde Kang, PhD, MD, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.

This study was supported by the National Natural Science Fund of China (81271976/H0605 and 81171763).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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